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1.
Opt Express ; 32(2): 1305-1313, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38297685

RESUMEN

We present a study of homodyne measurements of two-mode, vacuum-seeded, quadrature-squeezed light generated by four-wave mixing in warm rubidium vapor. Our results reveal that the vacuum squeezing can extend down to measurement frequencies of less than 1 Hz, and the squeezing bandwidth, similar to the seeded intensity-difference squeezing measured in this system, reaches up to approximately 20 MHz for typical pump parameters. By dividing the squeezing bandwidth into smaller frequency bins, we show that different sideband frequencies represent independent sources of two-mode squeezing. These properties are useful for quantum sensing and quantum information processing applications. We also investigate the impact of group velocity delays on the correlations in the system, which allows us to optimize the useful spectrum.

2.
Int J Eat Disord ; 57(4): 937-950, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38352982

RESUMEN

OBJECTIVE: Body mass index (BMI) is the primary criterion differentiating anorexia nervosa (AN) and atypical anorexia nervosa despite prior literature indicating few differences between disorders. Machine learning (ML) classification provides us an efficient means of accurately distinguishing between two meaningful classes given any number of features. The aim of the present study was to determine if ML algorithms can accurately distinguish AN and atypical AN given an ensemble of features excluding BMI, and if not, if the inclusion of BMI enables ML to accurately classify between the two. METHODS: Using an aggregate sample from seven studies consisting of individuals with AN and atypical AN who completed baseline questionnaires (N = 448), we used logistic regression, decision tree, and random forest ML classification models each trained on two datasets, one containing demographic, eating disorder, and comorbid features without BMI, and one retaining all features and BMI. RESULTS: Model performance for all algorithms trained with BMI as a feature was deemed acceptable (mean accuracy = 74.98%, mean area under the receiving operating characteristics curve [AUC] = 74.75%), whereas model performance diminished without BMI (mean accuracy = 59.37%, mean AUC = 59.98%). DISCUSSION: Model performance was acceptable, but not strong, if BMI was included as a feature; no other features meaningfully improved classification. When BMI was excluded, ML algorithms performed poorly at classifying cases of AN and atypical AN when considering other demographic and clinical characteristics. Results suggest a reconceptualization of atypical AN should be considered. PUBLIC SIGNIFICANCE: There is a growing debate about the differences between anorexia nervosa and atypical anorexia nervosa as their diagnostic differentiation relies on BMI despite being similar otherwise. We aimed to see if machine learning could distinguish between the two disorders and found accurate classification only if BMI was used as a feature. This finding calls into question the need to differentiate between the two disorders.


Asunto(s)
Anorexia Nerviosa , Humanos , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/epidemiología , Índice de Masa Corporal , Comorbilidad , Encuestas y Cuestionarios
3.
Multivariate Behav Res ; 59(2): 342-370, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38358370

RESUMEN

Cross-lagged panel models (CLPMs) are commonly used to estimate causal influences between two variables with repeated assessments. The lagged effects in a CLPM depend on the time interval between assessments, eventually becoming undetectable at longer intervals. To address this limitation, we incorporate instrumental variables (IVs) into the CLPM with two study waves and two variables. Doing so enables estimation of both the lagged (i.e., "distal") effects and the bidirectional cross-sectional (i.e., "proximal") effects at each wave. The distal effects reflect Granger-causal influences across time, which decay with increasing time intervals. The proximal effects capture causal influences that accrue over time and can help infer causality when the distal effects become undetectable at longer intervals. Significant proximal effects, with a negligible distal effect, would imply that the time interval is too long to estimate a lagged effect at that time interval using the standard CLPM. Through simulations and an empirical application, we demonstrate the impact of time intervals on causal inference in the CLPM and present modeling strategies to detect causal influences regardless of the time interval in a study. Furthermore, to motivate empirical applications of the proposed model, we highlight the utility and limitations of using genetic variables as IVs in large-scale panel studies.


Asunto(s)
Modelos Estadísticos , Estudios Transversales , Causalidad
4.
J Comput Chem ; 44(14): 1395-1403, 2023 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-36805580

RESUMEN

Because of instability issues presented by metal halide perovskites based on methylammonium (MA), its replacement to Cs has emerged as an alternative to improve the materials' durability. However, the impact of this replacement on electronic properties, especially gap energy and bulk Rashba splitting remains unclear since electrostatic interactions from organic cations can play a crucial role. Through first-principles calculations, we investigated how organic/inorganic cations impact the electronic properties of MAPbI 3 and CsPbI 3 perovskites. Although at high temperatures the organic cation can assume spherical-like configurations due to its rotation into the cages, our results provide a complete electronic mechanism to show, from a chemical perspective based on ab initio calculations at 0 K , how the MA dipoles suppression can reduce the MAPbI 3 gap energy by promoting a degeneracy breaking in the electronic states from the PbI 3 framework, while the dipole moment reinforcement is crucial to align theory ↔ experiment, increasing the bulk Rashba splitting through higher Pb off-centering motifs. The lack of permanent dipole moment in Cs results in CsPbI 3 polymorphs with a pronounced Pb on-centering-like feature, which causes suppression in their respective bulk Rashba effect.

5.
Hematol Oncol ; 41(1): 108-119, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36251503

RESUMEN

Patients with relapsed or refractory lymphoma have limited treatment options, requiring newer regimens. In this Phase 1/2 study (NCT03769181), we assessed the safety, efficacy, and pharmacokinetics of isatuximab (Isa, anti-CD38 antibody) in combination with cemiplimab (Cemi, anti-programmed death-1 [PD-1] receptor antibody; Isa + Cemi) in patients with classic Hodgkin lymphoma (cHL), diffuse large B-cell lymphoma (DLBCL), and peripheral T-cell lymphoma (PTCL). In Phase 1, we characterized the safety and tolerability of Isa + Cemi with planned dose de-escalation to determine the recommended Phase 2 dose (RP2D). Six patients in each cohort were treated with a starting dose of Isa + Cemi to determine the RP2D. In Phase 2, the primary endpoints were complete response in Cohort A1 (cHL anti-PD-1/programmed death-ligand 1 [PD-L1] naïve), and objective response rate in Cohorts A2 (cHL anti-PD-1/PD-L1 progressors), B (DLBCL), and C (PTCL). An interim analysis was performed when the first 18 (Cohort A1), 12 (Cohort A2), 17 (Cohort B), and 11 (Cohort C) patients in Phase 2 had been treated and followed up for 24 weeks. Isa + Cemi demonstrated a manageable safety profile with no new safety signals. No dose-limiting toxicities were observed at the starting dose; thus, the starting dose of each drug was confirmed as the RP2D. Based on the Lugano 2014 criteria, 55.6% (Cohort A1), 33.3% (Cohort A2), 5.9% (Cohort B), and 9.1% (Cohort C) of patients achieved a complete or partial response. Pharmacokinetic analyses suggested no effect of Cemi on Isa exposure. Modest clinical efficacy was observed in patients with cHL regardless of prior anti-PD-1/PD-L1 exposure. In DLBCL or PTCL cohorts, interim efficacy analysis results did not meet prespecified criteria to continue enrollment in Phase 2 Stage 2. Isa + Cemi did not have a synergistic effect in these patient populations.


Asunto(s)
Enfermedad de Hodgkin , Linfoma de Células B Grandes Difuso , Linfoma de Células T Periférico , Humanos , Antígeno B7-H1 , Anticuerpos Monoclonales Humanizados/efectos adversos , Enfermedad de Hodgkin/patología , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células T Periférico/tratamiento farmacológico
6.
Behav Genet ; 53(1): 63-73, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36322200

RESUMEN

Establishing causality is an essential step towards developing interventions for psychiatric disorders, substance use and many other conditions. While randomized controlled trials (RCTs) are considered the gold standard for causal inference, they are unethical in many scenarios. Mendelian randomization (MR) can be used in such cases, but importantly both RCTs and MR assume unidirectional causality. In this paper, we developed a new model, MRDoC2, that can be used to identify bidirectional causation in the presence of confounding due to both familial and non-familial sources. Our model extends the MRDoC model (Minica et al. in Behav Genet 48:337-349,  https://doi.org/10.1007/s10519-018-9904-4 , 2018), by simultaneously including risk scores for each trait. Furthermore, the power to detect causal effects in MRDoC2 does not require the phenotypes to have different additive genetic or shared environmental sources of variance, as is the case in the direction of causation twin model (Heath et al. in Behav Genet 23:29-50,  https://doi.org/10.1007/BF01067552 , 1993).


Asunto(s)
Trastornos Mentales , Humanos , Factores de Riesgo , Causalidad , Fenotipo , Estudio de Asociación del Genoma Completo
7.
PLoS Med ; 19(5): e1004000, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35584178

RESUMEN

BACKGROUND: Socioeconomic factors have been consistently associated with suicide, and economic recessions are linked to rising suicide rates. However, evidence on the impact of socioeconomic interventions to reduce suicide rates is limited. This study investigates the association of the world's largest conditional cash transfer programme with suicide rates in a cohort of half of the Brazilian population. METHODS AND FINDINGS: We used data from the 100 Million Brazilian Cohort, covering a 12-year period (2004 to 2015). It comprises socioeconomic and demographic information on 114,008,317 individuals, linked to the "Bolsa Família" programme (BFP) payroll database, and nationwide death registration data. BFP was implemented by the Brazilian government in 2004. We estimated the association of BFP using inverse probability of treatment weighting, estimating the weights for BFP beneficiaries (weight = 1) and nonbeneficiaries by the inverse probability of receiving treatment (weight = E(ps)/(1-E(ps))). We used an average treatment effect on the treated (ATT) estimator and fitted Poisson models to estimate the incidence rate ratios (IRRs) for suicide associated with BFP experience. At the cohort baseline, BFP beneficiaries were younger (median age 27.4 versus 35.4), had higher unemployment rates (56% versus 32%), a lower level of education, resided in rural areas, and experienced worse household conditions. There were 36,742 suicide cases among the 76,532,158 individuals aged 10 years, or older, followed for 489,500,000 person-years at risk. Suicide rates among beneficiaries and nonbeneficiaries were 5.4 (95% CI = 5.32, 5.47, p < 0.001) and 10.7 (95% CI = 10.51, 10.87, p < 0.001) per 100,000 individuals, respectively. BFP beneficiaries had a lower suicide rate than nonbeneficiaries (IRR = 0.44, 95% CI = 0.42, 0.45, p < 0.001). This association was stronger among women (IRR = 0.36, 95% CI = 0.33, 0.38, p < 0.001), and individuals aged between 25 and 59 (IRR = 0.41, 95% CI = 0.40, 0.43, p < 0.001). Study limitations include a lack of control for previous mental disorders and access to means of suicide, and the possible under-registration of suicide cases due to stigma. CONCLUSIONS: We observed that BFP was associated with lower suicide rates, with similar results in all sensitivity analyses. These findings should help to inform policymakers and health authorities to better design suicide prevention strategies. Targeting social determinants using cash transfer programmes could be important in limiting suicide, which is predicted to rise with the economic recession, consequent to the Coronavirus Disease 2019 (COVID-19) pandemic.


Asunto(s)
COVID-19 , Prevención del Suicidio , Adulto , Brasil/epidemiología , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Factores Socioeconómicos
8.
J Allergy Clin Immunol ; 147(1): 296-308, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32446963

RESUMEN

BACKGROUND: Having a penicillin allergy label associates with a higher risk for antibiotic resistance and increased health care use. OBJECTIVE: We sought to assess the accuracy of skin tests and specific IgE quantification in the diagnostic evaluation of patients reporting a penicillin/ß-lactam allergy. METHODS: We performed a systematic review and diagnostic accuracy meta-analysis, searching on MEDLINE, Scopus, and Web of Science. We included studies conducted in patients reporting a penicillin allergy and in whom skin tests and/or specific IgE quantification were performed and compared with drug challenge results. We quantitatively assessed the accuracy of diagnostic tests with bivariate random-effects meta-analyses. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. Studies' quality was evaluated using QUADAS-2 criteria. RESULTS: We included 105 primary studies, assessing 31,761 participants. Twenty-seven studies were assessed by bivariate meta-analysis. Skin tests had a summary sensitivity of 30.7% (95% CI, 18.9%-45.9%) and a specificity of 96.8% (95% CI, 94.2%-98.3%), with a partial area under the summary receiver-operating characteristic curve of 0.686 (I2 = 38.2%). Similar results were observed for subanalyses restricted to patients reporting nonimmediate maculopapular exanthema or urticaria/angioedema. Specific IgE had a summary sensitivity of 19.3% (95% CI, 12.0%-29.4%) and a specificity of 97.4% (95% CI, 95.2%-98.6%), with a partial area under the summary receiver-operating characteristic curve of 0.420 (I2 = 8.5%). Projected predictive values mainly reflect the low frequency of true penicillin allergy. CONCLUSIONS: Skin tests and specific IgE quantification appear to have low sensitivity and high specificity. Because current evidence is insufficient for assessing the role of these tests in stratifying patients for delabeling, we identified key requirements needed for future studies.


Asunto(s)
Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/inmunología , Penicilinas/efectos adversos , Hipersensibilidad a las Drogas/patología , Humanos , Inmunoglobulina E/inmunología , Penicilinas/uso terapéutico , Pruebas Cutáneas
9.
Soc Psychiatry Psychiatr Epidemiol ; 56(10): 1779-1790, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33782727

RESUMEN

PURPOSE: Understanding long-term patterns of suicide methods can inform public health policy and prevention strategies. In Brazil, firearm-related policies may be one salient target for suicide prevention. This study describes trends in method-specific suicide at the national and state-levels in Brazil, with a particular focus on firearm-related suicides. METHODS: Brazilian mortality data for suicide and undetermined intent among people aged 10 years and older between 2000 and 2017 were obtained from the National Mortality Information System. We examined national and state-level trends in age-standardised suicide rates for hanging, self-poisoning, firearms, jumping from a high place, other, and unspecified methods. We also compared total rates of mortality from suicide and undetermined intent over the period. Applying Joinpoint regression, we tested changes in trends of firearm-specific suicide rates. RESULTS: The total suicide rate increased between 2000 and 2017. Rates of hanging, self-poisoning by drugs or alcohol and jumping from a high place showed the largest increases, while firearm-specific suicide rates decreased over the study period. Trends in methods of suicide varied by sex and state. CONCLUSION: It is of public health concern that suicide rates in Brazil have risen this millennium. Restricting access to firearms might be an effective approach for reducing firearm-specific suicides, especially in states where firearm availability remains particularly high. Treatment and management of substance misuse may also be an important target for suicide prevention policies. More work is needed to understand the causes of rising suicide rates in Brazil and to improve the mental health of the population.


Asunto(s)
Armas de Fuego , Suicidio , Brasil/epidemiología , Homicidio , Humanos , Salud Pública
10.
Knee Surg Sports Traumatol Arthrosc ; 29(11): 3512-3524, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33993320

RESUMEN

PURPOSE: Despite being a significant public health problem, ankle sprains' prognostic factors are largely unknown. This review aimed to systematically analyze the literature on acute ankle sprains to compare the prognosis of a combined anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments rupture with an isolated ATFL rupture in terms of progression to chronic ankle instability and other clinical outcomes. METHODS: The databases for Pubmed, CENTRAL and Web of Science were searched. Clinical studies reporting the prognostic effect of combined ATFL-CFL rupture versus an isolated ATFL rupture in conservatively treated ankle sprains, with a minimum follow-up of 12 months, were eligible for inclusion. Only studies with a reliable diagnostic method for anterolateral ankle ligaments evaluation, namely ultrasonography, magnetic resonance imaging, arthrography or stress tenography, were included. The relative risk (RR), along with the 95% confidence interval (CI), was used to quantitatively analyze the main outcomes. RESULTS: Nine papers were selected for inclusion, of which five were suitable for quantitative analysis. None of them found a statistically significant correlation between ligament injury severity and progression to chronic instability. Concerning other clinical outcomes, three studies found a statistically significant correlation between a combined ligament injury and a worse clinical prognosis. From the quantitative analysis, the relative risk (RR) of chronic ankle instability in a single versus a combined ligament rupture showed no significant difference. CONCLUSION: A significant statistical correlation between a combined ATFL-CFL rupture and chronic ankle instability, compared to an isolated ATFL rupture, was not found. There is, however, fair evidence showing a worse clinical outcome score in the combined ruptures, as well as a decreased return to full sports activities. The use of reliable and accessible diagnostic methods to determine the number of ruptured ligaments might have a role in managing severe ankle sprains. LEVEL OF EVIDENCE: Level III.


Asunto(s)
Inestabilidad de la Articulación , Ligamentos Laterales del Tobillo , Esguinces y Distensiones , Tobillo , Articulación del Tobillo , Humanos , Ligamentos Laterales del Tobillo/lesiones , Ligamentos Articulares/lesiones , Esguinces y Distensiones/complicaciones
11.
Int J Mol Sci ; 22(21)2021 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-34769158

RESUMEN

Phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) is an essential plasma membrane component involved in several cellular functions, including membrane trafficking and cytoskeleton organization. This function multiplicity is partially achieved through a dynamic spatiotemporal organization of PI(4,5)P2 within the membrane. Here, we use a Förster resonance energy transfer (FRET) approach to quantitatively assess the extent of PI(4,5)P2 confinement within the plasma membrane. This methodology relies on the rigorous evaluation of the dependence of absolute FRET efficiencies between pleckstrin homology domains (PHPLCδ) fused with fluorescent proteins and their average fluorescence intensity at the membrane. PI(4,5)P2 is found to be significantly compartmentalized at the plasma membrane of HeLa cells, and these clusters are not cholesterol-dependent, suggesting that membrane rafts are not involved in the formation of these nanodomains. On the other hand, upon inhibition of actin polymerization, compartmentalization of PI(4,5)P2 is almost entirely eliminated, showing that the cytoskeleton network is the critical component responsible for the formation of nanoscale PI(4,5)P2 domains in HeLa cells.


Asunto(s)
Citoesqueleto/metabolismo , Fosfatidilinositol 4,5-Difosfato/metabolismo , Membrana Celular/metabolismo , Transferencia Resonante de Energía de Fluorescencia , Células HeLa , Humanos , Microdominios de Membrana/metabolismo , Microscopía , Fosfatidilinositol 4,5-Difosfato/análisis
12.
Molecules ; 25(17)2020 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-32858905

RESUMEN

Phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) is a minor but ubiquitous component of the inner leaflet of the plasma membrane of eukaryotic cells. However, due to its particular complex biophysical properties, it stands out from its neighboring lipids as one of the most important regulators of membrane-associated signaling events. Despite its very low steady-state concentration, PI(4,5)P2 is able to engage in a multitude of simultaneous cellular functions that are temporally and spatially regulated through the presence of localized transient pools of PI(4,5)P2 in the membrane. These pools are crucial for the recruitment, activation, and organization of signaling proteins and consequent regulation of downstream signaling. The present review showcases some of the most important PI(4,5)P2 molecular and biophysical properties as well as their impact on its membrane dynamics, lateral organization, and interactions with other biochemical partners.


Asunto(s)
Membrana Celular , Fosfatidilinositol 4,5-Difosfato , Sistemas de Mensajero Secundario , Animales , Membrana Celular/química , Membrana Celular/metabolismo , Humanos , Fosfatidilinositol 4,5-Difosfato/química , Fosfatidilinositol 4,5-Difosfato/metabolismo
13.
Opt Lett ; 44(3): 646-649, 2019 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-30702700

RESUMEN

We describe the experimental observation of nonrectilinear trajectories of a nearly Gaussian light beam propagating in free space, after reflecting from a glass-air interface near critical incidence. The angular-dependent reflection coefficients modulate the incident beam's angular spectrum, shifting the reflected beam from the rectilinear path predicted by geometrical optics. The beam trajectory shows strong dependence on the angle of incidence, changing from rectilinear to oscillatory within 0.07°. Our experimental results are in good agreement with theoretical predictions for the trajectories followed by the intensity peak of the reflected beam.

14.
Allergy ; 74(4): 698-708, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30447164

RESUMEN

BACKGROUND: Refined phenotyping of allergic diseases may unravel novel phenotypes. Conjunctivitis as an independent disorder has never been approached. AIM: To identify distinct classes of allergic respiratory diseases using latent class analysis (LCA) and distinguish each class using classification and regression tree (CART) analysis. METHODS: Seven hundred and twenty-eight adults from the Portuguese general population study ICAR had a structured medical interview combined with blood collection, skin prick tests, spirometry with bronchodilation, and exhaled nitric oxide. LCA was applied to 19 variables. The CART algorithm selected the most likely variables distinguishing LCA-classes. RESULTS: A six-class model was obtained. Class 1 (25%): nonallergic participants without bronchial or ocular symptoms. Classes 2 (22%) and 3 (11%): nasal and ocular (low levels) symptoms without nasal impairment, monosensitized (Class 2) or polysensitized (Class 3). Class 4 (13%): polysensitized participants with high levels of nasal and ocular symptoms, and nasal impairment. Classes 5 (16%) and 6 (14%): high level of nasal, bronchial and ocular symptoms with nasal impairment (non-allergic or polysensitized, respectively). Participants in classes 5 and 6 had more bronchial exacerbations and unscheduled medical visits (P < 0.001). Ocular symptoms were significantly higher in classes with nasal impairment, compared to those without impairment (P < 0.001) or no nasal symptom (P < 0.001). CART highlighted ocular symptoms as the most relevant variable in distinguishing LCA-classes. CONCLUSION: Novel severe phenotypes of participants with co-occurrence of ocular, nasal and bronchial symptoms, and exacerbation-prone were identified. The tree algorithm showed the importance of the ocular symptoms in the expression of allergic diseases phenotypes.


Asunto(s)
Asma/diagnóstico , Oftalmopatías/inmunología , Análisis de Clases Latentes , Adulto , Algoritmos , Asma/clasificación , Conjuntivitis , Oftalmopatías/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fenotipo , Portugal
15.
Opt Lett ; 43(16): 4037-4040, 2018 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-30106946

RESUMEN

We experimentally study the Goos-Hänchen shift of a focused Gaussian optical beam in the critical region of incidence. We directly measure the beam's shift evaluated from the displacement of the location of the beam's intensity peak and its centroid by a novel image analysis method. We verify that the evaluation method has a dramatic impact on the physics of beam shift phenomena. The influence of wavelength, beam waist, and propagation distance on the beam shift is studied. Our experimental results confirm recent theoretical predictions about the composite Goos-Hänchen shift, including the observation of negative shifts of the beam's intensity peak.

16.
Int Arch Allergy Immunol ; 176(3-4): 234-238, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29788022

RESUMEN

BACKGROUND: Beta-lactam allergy is overdiagnosed. Diagnosis of penicillin allergy has been associated with a greater use of hospital resources and an increased risk of antibiotic-resistant infections, although this issue remains poorly studied in children. We aimed to compare patient characteristics and use of hospital resources in hospitalized children with and without a record of penicillin allergy. METHODS: We identified all hospitalizations in children labelled as being allergic to penicillin in a database containing all hospitalizations in Portuguese public hospitals between 2000 and 2014, and compared these with a similar number of age-, sex-, and main diagnosis-matched hospitalizations without a penicillin allergy label. Comparisons were made for length of hospital stay, comorbidities (Charlson Comorbidity Index), in-hospital mortality, and hospitalization costs. RESULTS: We identified 1,718 hospitalizations corresponding to children labelled as penicillin-allergic. Compared with patients without such a label, these children had longer hospital stays (mean 5 vs. 4 days, p = 0.03) and a higher comorbidity index (mean 0.11 vs. 0.09, p < 0.001). Hospitalization costs were also higher (EUR 2,071 vs. 1,798), but the difference was not significant (p = 0.12). CONCLUSIONS: Hospitalizations of children labelled as allergic to penicillin are associated with longer hospital stays, more comorbidities, and a tendency towards higher hospitalization costs. An accurate diagnosis of penicillin allergy based on clinical history and confirmatory tests is therefore essential in all paediatric patients.


Asunto(s)
Hipersensibilidad a las Drogas/epidemiología , Hospitalización , Penicilinas/efectos adversos , Adolescente , Niño , Preescolar , Atención a la Salud , Femenino , Humanos , Lactante , Recién Nacido , Tiempo de Internación , Masculino
17.
Ann Allergy Asthma Immunol ; 120(2): 190-194.e2, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29413343

RESUMEN

BACKGROUND: Penicillin allergy is commonly reported, but only a minority of claimants has a confirmed diagnosis. Nevertheless, patients labeled as having penicillin allergy are treated with second-line antibiotics, which are more expensive and less effective, possibly increasing the risk of drug-resistant infections. OBJECTIVE: To compare hospitalizations with and without registration of penicillin allergy concerning their morbidity and hospital resource use. METHODS: We analyzed a national administrative database containing a registration of all Portuguese hospitalizations from 2000 to 2014. All episodes occurring in adults with a penicillin allergy registration were compared with an equal number of hospitalizations without such registration and matched for inpatients' age, sex, and main diagnosis. We compared those episodes concerning their length of stay, hospital price charges, comorbidities, and frequency of drug-resistant infections. Differences between medical and surgical hospitalizations were explored. RESULTS: Hospitalizations with registration of penicillin allergy (n = 102,872) had a longer average length of stay than the remainder episodes (8 vs 7 days; P < .001) and higher hospital charges (3,809.0 vs 3,490.0 USD; P < .001). Inpatients with penicillin allergy registration also had a higher mean Charlson Comorbidity Index (0.91 vs 0.76; P < .001) and a significantly higher frequency of infections by several agents, including methicillin-resistant Staphylococcus aureus, Enterococcus species, and Escherichia coli. Among surgical episodes, septicemia was 1.2-fold more frequent among penicillin allergy cases. CONCLUSION: Hospitalizations with registration of penicillin allergy are associated with increased economic costs and frequency of infections by drug-resistant agents, reinforcing the need to establish a correct diagnosis of penicillin allergy.


Asunto(s)
Alérgenos/inmunología , Infecciones Bacterianas/epidemiología , Hipersensibilidad a las Drogas/epidemiología , Hospitalización/estadística & datos numéricos , Penicilinas/inmunología , Adulto , Anciano , Comorbilidad , Costos y Análisis de Costo , Femenino , Precios de Hospital , Humanos , Masculino , Persona de Mediana Edad , Portugal/epidemiología
18.
Int Braz J Urol ; 44(4): 800-804, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29757574

RESUMEN

OBJECTIVE: To report our institutional experience with penile refracture, including demographic data, recurrence time, etiology and operative findings in the first and second episodes. MATERIALS AND METHODS: Between January 1982 and September 2017, 281 patients underwent surgical treatment for penile fracture (PF) at our institution. Demographic data, clinical presentation, besides operative findings and follow-up of patients with relapsed PF were retrospectively assessed by reviewing medical records. RESULTS: Of a total of 281 cases of PF operated at our institution, 3 (1.06%) patients experienced two episodes of trauma. Age ranged from 38 - 40 years (mean: 39.3). The recurrence time varied from 45 to 1560 days (mean: 705). Two patients presented the new fracture episode at the same site of the previous lesion, while in the other case the lesion was observed at another site. CONCLUSION: Recurrent FP is an extremely rare entity. The risk factors for its occurrence are still unknown. Although the lesion of the corpus cavernosum ipsilateral to the scar tissue of the prior FP is more common, contralateral rupture may be present. Nevertheless, prospective studies with larger samples should be conducted.


Asunto(s)
Pene/lesiones , Adulto , Humanos , Masculino , Pene/cirugía , Enfermedades Raras , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Rotura/etiología , Rotura/cirugía , Factores de Tiempo
19.
Opt Express ; 25(24): 30105-30114, 2017 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-29221044

RESUMEN

Phased arrays are expected to play a critical role in visible and infrared wireless systems. Their improved performance compared to single element antennas finds uses in communications, imaging, and sensing. However, fabrication of photonic antennas and their feeding network require long element separation, leading to the appearance of secondary radiation lobes and, consequently, crosstalk and interference. In this work, we experimentally show that by arranging the elements according to the Fermat's spiral, the side lobe level (SLL) can be reduced. This reduction is proved in a CMOS-compatible 8-element array, revealing a SLL decrement of 0.9 dB. Arrays with larger numbers of elements and inter-element spacing are demonstrated through an spatial light modulator (SLM) and an SLL drop of 6.9 dB is measured for a 64-element array. The reduced SLL, consequently, makes the proposed approach a promising candidate for applications in which antenna gain, power loss, or information security are key requirements.

20.
Opt Lett ; 42(23): 4966-4969, 2017 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-29216157

RESUMEN

We investigate, both theoretically and experimentally, optical image cloning via electromagnetic induced absorption (EIA). We demonstrate the transfer of small 2D real images imprinted onto a strong coupling beam to a weak probe beam in a Rb vapor cell. We show through EIA that the coupling beam's image is cloned beyond the usual diffraction, with a potential improvement in spatial resolution of the cloned image by a factor of three in comparison to that of the original coupling beam. Optical cloning through EIA is based on position selective nonlinear absorption, and it does not rely on spatial modulation of the refractive index.

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